How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $363.08 | Professional | None | $177.83 | $177.83 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $363.08 | Facility | None | $186.21 | $186.21 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $380.19 | Professional | None | $186.21 | $186.21 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $537.03 | Facility | None | $524.81 | $524.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $323.59 Typical High $380.19 | Facility | None | $302.00 | $323.59 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $1,698.24 | Professional | None | $251.19 | $257.04 | $1,698.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,187.76 | Facility | None | $912.01 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $467.74 | Professional | None | $239.88 | $309.03 | $467.74 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $309.03 | Professional | None | $112.20 | $186.21 | $309.03 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $181.97 | Professional | 52 · Reduced service | $89.13 | $89.13 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $72.44 | Professional | 53 · Discontinued | $35.48 | $35.48 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $53.70 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $36.31 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $141.25 Median $199.53 Typical High $223.87 | Professional | UE · Used equipment | $141.25 | $199.53 | $223.87 |
Where Indiana sits
The same service costs 3.0 times more in Iowa than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 50th of 51
$186
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.